Weekly releases (1997–2007) -
Volume 6,
Issue 43,
24 October 2002

Volume 6,
Issue 43,
2002

With its publication on 9 October, the decision on the EU's new programme of Community
action in the field of public health has entered into force (1). A major part of the programme
concerns communicable diseases, and there is a particular commitment to strengthen
international rapid response capacity. The decision sets out the aims for the programme,
describes the actions and support measures, and creates the conditions for the European
Commission to develop structural arrangements, such as a technical coordination centre (2),
to ensure the effectiveness and the cohesion of measures and actions.

The US plan
As the United States (US) continues to expand counterterrorism capabilities, smallpox has
emerged as perhaps the most feared biological weapon because it is so contagious and
deadly. With the possibility of a war with Iraq, the US Defense Department has asked for
enough vaccine from the national smallpox vaccine stockpile for 1 million military personnel,
to be available by the beginning of November 2002. To protect US citizens against a
deliberate release of the smallpox virus, US federal experts have been working on a
comprehensive preparedness plan with two tracks: a (pre-event) vaccination programme for
the emergency medical workers most likely to see an initial case of smallpox, and a (post-
event) mass vaccination plan if an attack occurs. The latter is now available and has recently
been distributed to all states by the Centers for Disease Control and Prevention (CDC)
(http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp). The documentation
provided includes many detailed instructions and recommendations on the logistics that go
with such a massive campaign. Of particular interest are the forms included for obtaining
consent from people about to be vaccinated - a crucial issue. The manual states that following
a confirmed smallpox outbreak in the US, rapid voluntary vaccination of a large population
may be required.

Last week, the first case of probable variant Creutzfeldt-Jakob disease (vCJD) in a United
States (US) resident was documented in the Morbidity and Mortality Weekly Report (1). The
patient, a 22 year old woman living in Florida, first developed neuropsychiatric symptoms in
November 2001, and was initially reported in April 2002 (2).

Between 1995 and 2000, the incidence of confirmed serogroup C invasive meningococcal infection
(IMIC) in France, adjusted for undernotification, increased from 0.14 to 0.24 cases per 100 000
inhabitants. In 2001, the rate reached 0.40/100 000, which was attributable to an increase in the
incidence of all invasive meningococcal infections (IMI), and also to the fact that the proportion of IMIC
increased from 23% to 35% of all IMI(1).

The cumulative total of cases of gastroenteritis infected with the outbreak strain of Salmonella Enteritidis PT 14b (not known to be linked with foreign travel) reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre in England (PHLS CDSC) by the Laboratory of Enteric Pathogens (LEP) since 26 September is now 224 (1). All the outbreak related strains examined so far have similar plasmid profile and pulsed field gel electrophoresis patterns. The dates of onset for confirmed cases reported since 26 September, where available, range from 3 September to 13 October 2002 (figure) and the epidemic curve is consistent with continuing exposure to a source of infection. There have been two deaths.

During an ongoing investigation into a nosocomial outbreak of S. Enteritidis PT 6a (Nx, CpL) in London, where raw shell eggs were being used, the London Food, Water and Environmental Microbiology Laboratory (LFWE) tested 402 raw shell eggs obtained from the premises. Two hundred and forty of these were labelled as imported, and four of the 40 samples of six pooled whole eggs were positive. The Laboratory of Enteric Pathogens (LEP) at the Public Health Laboratory Service Communicable Disease Surveillance Centre (PHLS CDSC) confirmed the presence of S. Enteritidis PT 6 (one sample), S. Enteritidis PT 13a (one sample) and S. Enteritidis PT 14b (one sample). Of the 27 samples from the unlabelled eggs (162 eggs) one sample was positive for S. Enteritidis PT 6. Results are awaited on the final isolate. Since the raw eggs have been withdrawn from use no further cases have occurred. Hospitals in the United Kingdom are reminded that advice issued by the Chief Medical Officer in 1988 that raw shell eggs should be replaced with pasteurised eggs in recipes in institutions with high risk groups (1) is extant and must be adhered to if vulnerable patients are not to be put at risk.

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This year’s EFSA conference, Science, Food, Society, is constructed around the motto ‘contextualising risk assessment’ and will take place from 18–21 September in Parma. The call for posters is now open and early career researchers are particularly encouraged to submit a proposal by 2 April.

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A public call for expressions of interest as Commission appointees to the Advisory Forum of ECDC has been made. The selection procedure is looking to appoint representatives of non-governmental organisations representing patients, professional bodies or academia. The deadline for applications is 16 February 2018. Click here for more info.